Pharmacogenomics of ARVs

This was a collaborative study with W. Chantratita, S. Mahasirimongkol and Y. Tawon S. Chantarangsu (Ph.D. candidate) from with Mahidol University.

This study investigated the association of single nucleotide polymorphisms (SNPs) and haplotypes within CYP2B6, CYP3A4 and ABCB1 with nevirapine plasma concentrations in Thai women following nevirapine administration. CYP2B6 polymorphism has been reported to affect nevirapine oral clearance during chronic treatment but no association was observed with nevirapine AUC following a single intrapartum dose. However, other genetic polymorphisms within CYP2B6 impact nevirapine concentrations postpartum. In the absence of a CYP2B6 TGATC haplotype nevirapine plasma concentrations persisted longer postpartum (2-3 weeks), which may increase the risk of selecting NNRTI drug resistance mutations postpartum, and longer additional postpartum antiretroviral treatment to reduce the incidence of NNRTI resistance postpartum may be beneficial for this particular group of women.